I remember one specific call for an vehicle accident about 12 years ago. It was early in the morning and we were out on a fire alarm call across town when we get hit out for a wreck & they report one patient still in the vehicle, unconscious & breathing not verified, a Delta 2 response. (a delta 2 is the highest priority call indicating an immediate life threat)
Now it was still early in the morning and it had snowed about 4 or 5 inches of heavy wet snow, and most of the roads were still covered. We're released from the fire alarm and high tail it back across town in the engine, stoping at the end of the road the firehouse is on so one of the new guys can hope out and literally run to the station and get the ambulance. We had a medical "jump kit" on the engine and the guy driving was a medic so we had enough training & equipment to get us started on Pt care until the ambulance got there. So one of the guys, Mike, hops out and begins his 40 yard dash for the station to grab the ambulance and we continue about a quarter mile down the road to the scene.
As we pull up, I notice a gold 4 door Toyota that has wrecked into a garage where the side of garage door meets the wall. The driver is a 23 year old female, kind of slumped forward a little. (i distinctively remember her age & birthdate, turns out I was exactly 3 days older than her) There is some damage to the corner of the building, not to bad but still bad enough to consider the building unstable making the patient extraction a little more challenging, because now one wrong move of the vehicle, and part of the building can come down. So we add a rescue truck to the assignment and get to work. As "luck" would have it, aside from the medic, the rest of the crew was fairly new to the station, none of them having their EMT training. I had the training,but was just waiting to hear if I had passed the state exams. Bill, our Medic on the call, and also an Asst. Chief looks at me and says, "Your the closest thing i have to an actual EMT so glove up, hop in the back seat & hold C-spine (stabilization)." the rest of the guys started prepping for the extrication. So I glove up, take out the rear passenger door window and crawl in the back seat as the guys begin stabilizing the car to take off the doors. I make my way over behind the driver, looking around the car at the windshield & steering wheel trying to see if there's any evidence that the drive impacted any parts of the vehicles interior. Imidiately I notice some blood and hair on both the "A" post and the "B" post. (the part of the car body that supports the roof of the vehicle, from front to back they go in alphabetical order) I also notice some on the block wall that's directly outside of the drivers window. I relay the info to Bill and get situated inside to grab C-spine. (I'm 6'6" in full gear, in the back seat of a Toyota, needless to say its a bit cramped) I reach over the back seat and gently place my hands on the sides of her head so i can lift it into the normal upright position and as I begin to apply slight pressure to lift her head and I feel this "squish" with my left hand. Wondering WTF it was I pull my hand away and look to see my hand covered in blood and a piece of skull bone about the size of a silver dollar stuck to my palm with long bloody brown hair hanging from it.
I yell "ahhh, Bill.....we've got a serious problem!...."
Bill replies "what's that?" then looks in through the back window. I calmly show him my hand with the her pieces and parts still stuck to it.
"OH SHIT.....ok, we need to get her the fuck outta hear now.....rapid extract......and don't loose that!"
He lets the guys know there will be no car cutting, we're doing this quick & dirty. (to "properly" perform the extrication would have eaten up time this girl didn't have)
Luckily, they managed to get the front passenger door open just before my gruesome discovery, making the rapid extrication a little easier, and, the ambulance had just pulled up, it was time to go.
I grab C-spine, we quickly get a collar on her, wrap her head wond with gauze and bandages & begin the extrication. We get her out into the stretcher & into the back of the ambulance to start working on her. At some point a medic from another station, Rich, shows up & hops in the ambulance to help. We give him a quick run down then start cutting her cloths off to look for other injuries, start IVs and hook her up to the heart monitor. Rich, tries intubation, but there's teeth & blood in the way...he tries a few times then turns & says "here, you try"
I said "Dude!....I'm not a medic..."
He replied, "Don't worry about it, you can't do any worse than me" "Are you fuckin serious?!" I shot back.
"Yea god damn it, now come on!" basicaly this poor girl was in such bad shape that there weren't enough Medics to do everything that needed done, and "trying" was better than "not doing" at all. So we switch places and he starts talking me through it while beginning another task.
"Look for the (vocal) cords, do this, do that, ok try and place the tube" all of this while he's using suction to remove blood and help guid the Tube.
"Did you get it?" he asks
"I don't know!? I think it's in but I don't know!" I replied
Rich then says "Hook up the bag valve and give some breaths, I'll listen"
So I do, and sure as shit he looks at me and says "You Got It!!"
Bill looks up at me with a smirk and says "Beginners luck." (and it was) But before I can even catch a breath and take a second to soak in what i had just accomplished, the driver of the ambulance yells back "Give me some towels, I need a dam!" I turn and look at the floor and all this blood was running across the floor towards the front of the ambulance and into the step well for the side door. We throw a bunch of towels down, then Bill tells the kid driving "Lets Go!.....Presby,now!" and off we go.
I'm baggin her, and I cant help but notice the blank stare in her eyes, Rich & Bill are starting a central IV (into the jugular vein just below the neck) and pushing drugs to keep her alive. As we reach the tunnels the heart monitor goes into alarm.....she's starting to "crash."
Rich grabs the paddles, charges them up, places them on her and yells "CLEAR" Bill and I get clear and reply "CLEAR" to let Rich know we are in fact clear of the stretcher, then he whacks her. Her body kinda twitches a little bit (it's not the big lunge you see on tv) and her heart rhythm returns to something not quite normal, but acceptable considering the condition, but it lasts only for about 30 seconds, then she crashes again. We ended up shocking her about 3 or 4 more times and that's when I notice the blood gushing from the now solid red bandage, is starting to look clear,the damn of towels on the floor is also soaked, holding back a puddle of blood and the step well also has about an inch deep puddle of blood, and every time I squeeze the bag to give her a breath, a clear/redfish blood bubble inflates from the location of the head wound then pops. Basically what has happened is most of her blood, which is all over the floor of the ambulance, has been "replaced" with saline from the IV.
"ummm, Guys!?....her blood is turning clear..."
Bill & Rich look at each other as if to say "oh shit" then Bill asks the driver where we're at.
Mike the driver tells back "Bates St. About 2 minuets out"
Bill turns to me and says "you just keep bagging" then starts chest compressions. Then no sooner do we make our last turn towards Presbys ER, she flat lines. And as the monitor starts to make the infamous long "beep" tone to indicate flat line (no heart beat) I look down at her & I rember watch both pupils in her pretty blue eyes slowly dilate to about the size of a dime.
We pull into the ER & the trauma team is waiting. We get her out & right into a trauma room. I'm still bagging as the trauma team gathers around to start there job.
They push a few drugs then shock her a few times to no avail....then the Dr calls it, "OK people, Time of death 8:41" and then that's it. All the work we had done during the longest 10 min ride ever, is now null & void. We did what we could, but it was out of our hands.
Before leaving, we go over the ordeal with the trauma team again & they compliment us on the work we did, assuring us that we did everything we could and we did it right but today it just simply wasn't enough.
we head back to the ambulance. In side, it looks like a massacre & is totally trashed with gauze wrappers & empty IV bags & heart monitor cable just thrown about in a blood covered ambulance.
I walk around to the side door and open it to see coagulated blood kinda slide out onto the ground & go splat. Then I noticed blood down the side of the ambulance in a perfectly straight 3" wide pin stripe. The blood in the side step well was leaking out through a bad door seal and as we drove to the hospital, and worked its way down the side of the ambulance perfectly parallel to the red reflective strip thats supposed to be there.
It took about an hour just to clean up the ambulance enough to drive back and would take another 2 hours of scrubbing at the station to get it in service. But on the way back we swing by the scene to let the police know she didn't make it and just to take a look at what happened & how she wrecked. As it turns out she was on her way home from work driving on the snow covered roads when she lost control & hit the garage. When she hit the garage and the car stopped, she kept moving forward striking her head off off the "A" post then coming back and striking the "B" post and finally hitting the block wall just outside the drivers window. Hence the severe head trauma.
The car itself wasn't that bad, needed a bumper, fender and hood, that's all. The police also told us to look at the speedometer, it was stuck at 23 mph, the speed at wich she was traveling on impact.
As it would turn out, relatively low speed crash and no seat belt equaled out to a dead 23 year old girl.
It's a shame, but in this business you see a lot of death that could have been prevented. You just learn to accept it.
